What is the differential diagnosis of eosinophilic granulomatosis with polyangiitis ?
The differential diagnosis is:
- Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)
- Polyarteritis nodosa (PAN)
- Allergic bronchopulmonary aspergillosis (ABPA)
- Chronic eosinophilic pneumonia (CEP)
- Hypereosinophilic syndrome (HES)
- Rheumatoid arthritis
EGPA can be distinguished from the above diagnoses by the following:
- In contrast to the other ANCA-associated vasculitides, including MPA and GPA, EGPA is associated with asthma and eosinophilia.
- Kidney involvement and pulmonary nodule cavitation are much less common in EGPA compared to GPA.
- PAN is a medium-vessel vasculitis, and unlike EGPA, it does not involve the lung.
- CEP and ABPA are limited to lung involvement.
- ANCAs, asthma, and vasculitis are not features of HES, in contrast to EGPA.